REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO, LU ) S.S

AFFIDAVIT OF SAME PERSON

We, ROMELYN B. CHAN, married, a resident of Parian Oeste, Bauang, La

Union and JOSEFINA ASUNCION, widow, a resident of Sta. Rita, Bacnotan, La
Union, both of legal age, Filipino citizens, after having been duly sworn to in
accordance with law, depose and say:

That we personally know DATO A. CACDAC, also known as DATU A.

CACDAC, who is the owner of a parcel of land located at Parian Oeste, Bauang, La
Union under Tax Decl. No. __________________;

That as appearing in his Tax Decl. No. ______________ his name entered as
DATU A. CACDAC;

Whereas, as per his Drivers License his name spelled as DATO A. CACDAC;

That we are executing this affidavit is executed to attest to the truth of all
the foregoing facts that the names DATU A. CACDAC, and DATO A. CACDAC, refer
to one and the same person, we being close friends of his family for a long period
of time;

In the city of San Fernando, La Union, this _____ day of October, 2022.

ROMELY B. CHAN
Affiant-Unified ID#0111-3108926-1

JOSEFINA ASUNCION
Affiant/Sen. ID# 1689

SUBSCRIBED AND SWORN to before me, this _____ day of October, 2022
at San Fernando City, La Union.

Doc. No.
Page No.
Book No.
Series of 2022
 AFFIDAVIT OF LOSS

I, ALEX F. DACANAY, of legal age, widower, Filipino citizen, and a resident of Purok 4-Santiago
Norte, San Fernando City, La Union, after having been duly sworn to in accordance with law, depose
and say:

That I am husband of the late MA. LOURDES GATMEN;

That my said wife was the owner of one (1) cemetery lot, more particularly described, as
follows:

Lot Owner : Location : Certificate of Ownership

Ma. Lourdes Gatmen : Lawn M Block 5 Lot 3 # 347 La Union Memorial Park

San Fernando

That the Certificate of Ownership of said lot was among those which were either lost on files
where it was placed;

That despite diligent efforts to locate it, the same could not be found;

That I am now declaring the said Certificate as lost;

That I attest to the truth of all the foregoing facts and likewise for all legal intents and
purposes it may serve;

In the city of San Fernando, La Union, this 10th day of May, 2021.

ALEX F. DACANAY
Affiant-DL#A04-85-007506

REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO, LU )S.S

SUBSCRIBED AND SWORN to before me, this 10 TH day of May, 2021 at San Fernando City, La
Union, affiant is personally known to me.
Doc. No.
Page No.
Book No.
Series of 2021

REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO, LU ) S.S

AFFIDAVIT OF LOSS

I, NINO R. REALIN, of legal age, Filipino citizen, and a resident of Tamorong Santa Catalina,
Ilocos Sur, after having been duly sworn to in accordance with law, depose and say:

That I am the owner and possessor of one (1) unit motor vehicle, NISSAN CUBE WAGON,
bearing Plate # BEU 256, WITH Certificate of Registration CR No. 193546555;

That sometime on February 28, 2021, said vehicle was parked unattended at Brgy. San
Francisco, San Fernando City, La Union;

That after two hours when I went home, I noticed that the rear plate of said vehicle was
missing;

That I exerted all efforts to locate the same, but proved futile and I am declaring said plate as
lost;

That the same has never been confiscated by the proper authorities concerned for any cause;

That I attest to the truth of all the foregoing facts and likewise for all legal intents and
purposes it may serve;

In the city of San Fernando, La Union, this _____ day of __________, 2021.

NINO R. REALIN
Affiant
DL ID NO.

SUBSCRIBED AND SWORN to before me, this ____ day of ____________, 2021 at San Fernando
City, La Union, affiant is personally known to me.
Doc. No.
Page No.
Book No.
Series of 2021

REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO, LU ) S.S

AFFIDAVIT OF LOSS

I, SUSAN F. ORDOÑO, of legal age, married, Filipino citizen, and a resident of Dalumpinas Este,
San Fernando City, La Union, after having been duly sworn to in accordance with law, depose and say:

That I am a Group Manager of Boardwalk with a Cash Bond issued in my name dated June 10,
2014;

That the original copy of the said band issued by the Boardwalk was lost;

That despite diligent efforts to locate it, the same could not be found;

That I am now declaring the said ATM CARD was lost;

That I attest to the truth of all the foregoing facts and likewise for all legal intents and
purposes it may serve;

In the city of San Fernando, La Union, this 12th day of November, 2015.

SUSAN F. ORDOÑO
Affiant
 SUBSCRIBED AND SWORN to before me, this 12th day of November, 2015 at San Fernando
City, La Union, affiant is personally known to me.

Doc. No.
Page No.
Book No.
Series of 201

REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO, LU ) S.S

AFFIDAVIT OF LOSS

I, JAMER CEDRIC D. HERNANDEZ, of legal age, single, Filipino citizen, and a resident of Bry.
Sagayad, San Fernando City, La Union, after having been duly sworn to in accordance with law,
depose and say:

That I am the owner of one (1) unit motorized tricycle, HONDA, bearing Body Number 224
duly registered with the OFFICE OF THE CITY MAYOR, San Fernando City, La Union for the year 2020;

That I am applying for the renewal of business of said motorized tricycle;

That all the documents of the said motorized tricycle were lost for unknown reasons;

That despite diligent efforts to locate it, the same could not be found;

That I am now declaring the all the documents were lost, same has never encumbered to any
entities or persons;

That I attest to the truth of all the foregoing facts and likewise for all legal intents and
purposes it may serve.

In the city of San Fernando, La Union, this 31st day of May, 2021.

JAMER CEDRIC D. HERNANDEZ

Affiant
Prof.DL # A04-14-005905

SUBSCRIBED AND SWORN to before me, this 31 st day of May, 2021 at San Fernando City, La
Union, affiant is personally known to me.

Doc. No.
Page No.
Book No.
Series of 2021

Series of 2014

REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO, LU ) S.S

AFFIDAVIT OF LOSS

I, GLADYS ALELI FLORES TABADA, of legal age, single, Filipino citizen, and a resident of Lingsat,
City of San Fernando , La Union, after having been duly sworn to in accordance with law, depose and
say:

That I am a member/contributor of the Philhealth Insurance with Philhealth Identification

Number (PIN) 050252708593 ;

That I am religiously paying my contributions with the said insurance;

That as such the receipt of my contribution with OR NO. 41743024 for the month of January
to June , 2013. P150.00 per month was among those which were either lost where it was placed;

That despite diligent efforts to locate it, the same could not be found;

That I am now declaring the said OR was lost;

That I attest to the truth of all the foregoing facts and likewise for all legal intents and
purposes it may serve;

In the city of San Fernando, La Union, this 10TH day of October , 2013.

GLADYS ALELI FLORES TABADA

 Affiant

SUBSCRIBED AND SWORN to before me, this 10 th day of October, 2013 at San Fernando City,
La Union, affiant is personally known to me.

Doc. No.
Page No.
Book No.
Series of 2013

AFFIDAVIT OF LOSS

I, ERLINDA TADINA, of legal age, widow, Filipino citizen, and a resident of Poro , San Fernando
City, La Union, after having been duly sworn to in accordance with law, depose and say:

That I am the surviving wife of the late CAMILO TADINA, owner and possessor of a CEMETERY
LOT OF THE Holy Garden Memorial Park, San Fernando City, La Union, more particularly described as
follows:

LAWN ………………………………………………………………………………… M

BLOCK………………………………………………………………………………… 72

LOT…………………………………………………………………………………….. 1

TITLE NO. ……………………………………………………………………………

That the ORIGINAL TITLE of the said lot was among those which were either lost;

That despite diligent efforts to locate it, the same could not be found;

That I am now declaring the said title was lost;

That I attest to the truth of all the foregoing facts and likewise for all legal intents and
purposes it may serve;

In the city of San Fernando, La Union, this 4TH day of July, 2013
 ERLINDA TADINA
Affiant

REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO, LU )S.S

SUBSCRIBED AND SWORN to before me, this 4TH day of July, 2013 at San Fernando City, La
Union, affiant is personally known to me.

Doc. No.
Page No.
Book No.
Series of 2013

AFFIDAVIT OF LOSS

I, JESSIE R. MIRNADA, of legal age, single Filipino citizen, and a resident of #1 Rizal Ave.,
Ilocanos Sur, San Fernando City, La Union, after having been duly sworn to in accordance with law,
depose and say:

That I am the registered owner of one (1) motor vehicle, Mitsubishi Pajero Van, bearing Motor
Number 4D560X9289, Serial Chassis Number V44-3005800. Plate No.CST162, CR No. 4083617-6;

That the original copy of the said Registration of my motor vehicle was misplaced and/or lost
on files and I exerted all efforts to locate the same but proved futile;

That I am now declaring the said registration as lost for all legal intents and purposes

That I attest to the truth of all the foregoing.

In the city of San Fernando, La Union, this _______ day of ____________________.

 JESSIE R. MIRANDA
Affiant

REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO, LU )S.S

SUBSCRIBED AND SWORN to before me, this _____ day of _____________ at San Fernando
City, La Union, affiant is personally known to me.

Doc. No.
Page No.
Book No.
Series of 2012
REPUBLIC OF THE PHILIPPINES )

CITY OF SAN FERNANDO, LU ) S.S

AFFIDAVIT OF LOSS

I, JOEY Q. ESPINUEVA, of legal age, married, Filipino citizen, and a resident of Brgy. Ilocanos
Ilocanos Sur, San Fernando City, La Union, after having been duly sworn to in accordance with law,
depose and say:

That I am the registered owner of ‘JOEY’S PURIFIED WATER STATION” with business address
located at Brgy. Ilocanos Sur, San Fernando City, La Union;

That the following documents, follows:

A) Certificate of Business Registration

b) Unused Official Receipt

c) Ask for Receipt (BIR) and all other necessary papers/documents needed in the said business
were all lost due to flood;

That I exerted all my efforts to locate the same but proved futile;

That I attest to the truth of all the foregoing.

In the city of San Fernando, La Union, this 30th day of May, 2014.

JOEY Q. ESPINUEVA
 Affiant

SUBSCRIBED AND SWORN to before me, this 30 TH day of May, 2014at San Fernando City, La
Union, affiant is personally known to me

Doc. No.
Page No.
Book No.
Series of 2014
REPUBLIC OF THE PHILIPPINES )
CITY OF SAN FERNANDO, LU ) S.S
AFFIDAVIT OF LOSS
I, JONALYN B. ARAGON, of legal age, widow, Filipino citizen, and a resident of 213 San
Blas, Villasis, Pangasinan, after having been duly sworn to in accordance with law, depose and
say:

That I am an employee of PHILIPPINE PORTS AUTHORITY (PPA), Poro, San Fernando

City, La Union;

That I am the holder of the following:

a) PNB Passbook Dollar Account # 1020092870014

b) LBP Payroll Account # 2527-0292-98

c) AFPSLAI Green Passbook-Capital Contribution Account

d) AFPSLAI RED Passbook 71000200276559

e) Metrobank Passbook-Bauang, LU -718-3-79966886-7

f) Metrobank Passbook-San Fdo. Branch- 526-3-52611393-5

g) SSS, GSIS, & Pag-ibig Loyalty Card ID

h) BDO ATM CARD

i) Keys (house & office)

j) PCSLAI Passbook

That on June 15, 2021 at around 4:00 a.m I noticed that my bag containing the above
mentioned Identification Cards, Passbooks, ATM Cards, etc. were missing inside my boarding
house in Purok 7, Pgdalagan Norte, Kalye Patay, San Fernando City, La Union

That despite diligent efforts to locate it, the same could not be found;

That I am now declaring as lost and beyond recovery;

That I attest to the truth of all the foregoing facts and likewise for all legal intents and
purposes it may serve;

In the city of San Fernando, La Union, this 15th day of June, 2021.
 JONALYN B. ARAGON
Affiant- ID#

SUBSCRIBED AND SWORN to before me, this 15th day of June, 2021 at San Fernando
City, La Union, affiant is personally known to me.
Doc. No.
Page No.
Book no.
Series of 2021